Nugent Frank James, Vinther Anders, McGregor Alison, Thornton Jane S, Wilkie Kellie, Wilson Fiona
Physical Education and Sport Sciences Department, Faculty of Education and Health Sciences, University of Limerick, Limerick, Ireland
Sport and Human Performance Research Cluster, Health Research Institute, University of Limerick, Limerick, Ireland.
Br J Sports Med. 2021 Jan 4. doi: 10.1136/bjsports-2020-102533.
Low back pain (LBP) is common in rowers. Understanding rowing biomechanics may help facilitate prevention and improve rehabilitation.
To define the kinematics and muscle activity of rowers and to compare with rowers with current or LBP history.
Systematic review.
EMBASE, MEDLINE, Cumulative Index to Nursing and Allied Health Literature, Web of Science and Scopus from inception to December 2019. Grey literature was searched.
Experimental and non-experimental designs.
Primary outcomes were kinematics and muscle activity. Modified Quality Index (QI) checklist was used.
22 studies were included (429 participants). Modified QI score had a mean of 16.7/28 points (range: 15-21). Thirteen studies investigated kinematics and nine investigated muscle activity. Rowers without LBP ('healthy') have distinct kinematics (neutral or anterior pelvic rotation at the catch, greater hip range of motion, flatter low back spinal position at the finish) and muscle activity (trunk extensor dominant with less flexor activity). Rowers with LBP had relatively greater posterior pelvic rotation at the catch, greater hip extension at the finish and less efficient trunk muscle activity. In both groups fatigue results in increased lumbar spine flexion at the catch, which is greater on the ergometer. There is insufficient evidence to recommend one ergometer type (fixed vs dynamic) over the other to avoid LBP. Trunk asymmetries are not associated with LBP in rowers.
Improving clinicians' and coaches' understanding of safe and effective rowing biomechanics, particularly of the spine, pelvis and hips may be an important strategy in reducing incidence and burden of LBP.
下背痛（LBP）在赛艇运动员中很常见。了解赛艇运动生物力学可能有助于预防和改善康复。
确定赛艇运动员的运动学和肌肉活动，并与有当前或LBP病史的赛艇运动员进行比较。
系统评价。
从创刊到2019年12月的EMBASE、MEDLINE、护理及相关健康文献累积索引、科学引文索引和Scopus。检索了灰色文献。
实验性和非实验性设计。
主要结局为运动学和肌肉活动。使用改良质量指数（QI）清单。
纳入22项研究（429名参与者）。改良QI评分平均为16.7/28分（范围：15 - 21）。13项研究调查了运动学，9项研究调查了肌肉活动。没有LBP的赛艇运动员（“健康”）有独特的运动学（抓水时骨盆中立或前倾旋转，髋关节活动范围更大，结束时腰椎位置更平）和肌肉活动（以躯干伸肌为主，屈肌活动较少）。有LBP的赛艇运动员在抓水时骨盆后倾相对更大，结束时髋关节伸展更大，躯干肌肉活动效率更低。在两组中，疲劳都会导致抓水时腰椎前屈增加，在测力计上这种增加更明显。没有足够证据推荐一种测力计类型（固定型与动态型）优于另一种以避免LBP。赛艇运动员的躯干不对称与LBP无关。
提高临床医生和教练对安全有效的赛艇运动生物力学，特别是脊柱、骨盆和髋关节生物力学的理解，可能是降低LBP发病率和负担的重要策略。
